| NPI | 1972979243 |
|---|---|
| Former Name | VERONICA J MIELKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61143441) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21914) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2021-03-08 |